Contraception for adolescents with chronic rheumatic diseases

Autor(es)

Lourenco, Benito ; Kozu, Katia T. ; Leal, Gabriela N. ; Silva, Marco F. ; Fernandes, Elisabeth G. C. ; Franca, Camila M. P. ; Souza, Fernando H. C. ; Silva, Clovis A.

• Tipo de documento: Artigo de Revisão
• Fonte: Revista Brasileira de Reumatologia; v. 57, n. 1, p. 73-81, JAN-FEB 2017.
• Citações Web of Science: 4

Resumo

Contraception is an important issue and should be a matter of concern in every medical visit of adolescent and young patients with chronic rheumatic diseases. This narrative review discusses contraception methods in adolescents with juvenile systemic lupus erythematosus (JSLE), antiphospholipid syndrome (APS), juvenile idiopathic arthritis (JIA) and juvenile dermatomyositis (JDM). Barrier methods are safe and their use should be encouraged for all adolescents with chronic rheumatic diseases. Combined oral contraceptives (COC) are strictly prohibited for JSLE and APS patients with positive antiphospholipid antibodies. Reversible long-acting contraception can be encouraged and offered routinely to the JSLE adolescent patient and other rheumatic diseases. Progestin-only pills are safe in the majority of rheumatic diseases, although the main concern related to its use by adolescents is poor adherence due to menstrual irregularity. Depot medroxyprogesterone acetate injections every three months is a highly effective contraception strategy, although its long-term use is associated with decreased bone mineral density. COC or other combined hormonal contraceptive may be options for JIA and JDM patients. Oral levonorgestrel should be considered as an emergency contraception method for all adolescents with chronic rheumatic diseases, including patients with contraindication to COC. (C) 2016 Published by Elsevier Editora Ltda. (AU)

• Processo FAPESP: 14/14806-0 - Avaliação da reserva ovariana, anticorpo anti-corpo lúteo, citologia cérvico-vaginal, infecções do trato genital inferior, metabolômica e disfunção ovulatória em mulheres com artrite idiopática juvenil
• Beneficiário: Clovis Artur Almeida da Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 11/12471-2 - Avaliação da reserva ovariana, do anticorpo anti-corpo lúteo e da infecção do trato genital inferior de mulheres adultas com lúpus eritematoso sistêmico, síndrome de Behçet e arterite de Takayasu
• Beneficiário: Clovis Artur Almeida da Silva
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 09/51897-5 - Terapia anti-TNF em doenças auto-imunes reumatológicas: abordagem de aspectos peculiares
• Beneficiário: Eloisa Silva Dutra de Oliveira Bonfá
• Modalidade de apoio: Auxílio à Pesquisa - Temático